Hypos in middle of night, should i adjust lantus dose?

[eabhamurphy]

Hi there,
Im wondering what I should do if Im waking up at night around 3am feeling sick, i.e hypos: sweating, fast heart rate, headache, shaking.
Ive been adjusting my novorapid to the amount of carb portions Ive been eating with each meal and thats working alot better than the 'take 8 with each meal regardless' advice I was given by the nurse.
Im wondering would reducing my lantus from 20 to say 19 or 18/day be a good idea? My blood sugar is fine during the day but these middle of night hypos are a bit weird.
Any advice would be greatly appreciated.
Thanks,
Eabha

 

[LizzieP]

Hi there,

I think I might be tempted to do exactly what you say and decrease Lantus by maybe one unit to start with and see if that helps. If not, then maybe adjust by another 1 unit and see if there is a change (keeping an eye on your fasting levels) and so on. The same thing happened to me when I was newly diagnosed (are you?) and my (then) doctor told me to do this as I was on a pretty high dose of Lantus at the beginning. It worked! No more waking up in the night feeling dire. Good luck! Let us know how you get on.

 

[Vivienne]

I had the same problem, up at 2.00am, I now always do a BS check before bed and adjust the Lantus dose accordingly.
Good luck,
Vivienne

 

[LittleSue]

When you reduce the lantus, set an alarm for 3am (or whatever time you were hypo) and test your bs. Just to make sure you don't sleep through a milder hypo and get a liver dump.

 

[bmtest]

Hi

I am on Lantus and NovoRapid and this problem of hypo early morning was a problem.

I like Lantus because it works quickly and is active early and the benefits to me are great for low blood sugars while I am asleep.

Therefore what I do is test before I go to bed and my reading will be between 4 & 7 so I have 3 biscuits before going to bed which counters the hypo and usually give me a reading of 3-4 when I awake

If you give less Lantus you will probably find it runs out early evening and end up using more NovoRapid faced with a choice of splitting the Lantus.

Best wishes

 

[cugila]

Hi bmtest

Your early morning reading is too low. Anything below 4 mmol/l is considered Hypo territory. Not recommended.

Try eating a bit more food before bed so that your level is slightly higher. Between 4 - 7 is not ideal for the night, that is more what you should aim for before a meal or on waking.

Ken.

 

[eabhamurphy]

Thanks for all the tips guys!
Ive lowered by lantus by 2 units and this seems to be working quite well, i wake up at 3 am to check BG. Have had one bad hypos during day but I think this is due to my giving too much novorapid at meal times.
Diagnosed a week yesterday...what a week it has been. This forum is great though. So helpful Eva

 

[donnellysdogs]

Hi
What time do you take your lantus injection?
I suffered the most awful hypo's between 3am -7am for as many years as I can remember (Diagnosed 1986).
I used to take my lantus before going to bed, as this is what the consultant and nurses advised. I thought there had to be a way to get rid of them, and thought if I caould change my dose to the morning then this would get rid of my night hypo's........anyway to cut a long story short, I started off moving my Lantus from 10pmish to tea time (normally 6pm-ish), and I was going to do this for a week before moving it to lunch and then breakfast, however................from within 3 days of moving my dosage to teatime my hypo's have practically stopped at night time, and I rarely get them through out the day either (2 hypo's in past 12 months).
During the summer I also reduce my lantus dose from 31 to 29, as I am much more active in the garden during the day.
My advice has to be try taking the lantus at teatime, give it a week at least for your body to react and adjust itself. Make sure you are testing as much as possible day and evening.
I find that providing my BS is over 4.5 at 10pm I can drink a small glass of pure orange juice before going to bed, and I will not have any hypo's. My husband wakes me at 4 am before going to work and I check my sugars and the results are always between 4 and 9. As he has woken me and blood sugars naturally increase when you wake up, I may have a digestive biscuit if the BS are 4, but apart from that I just go back to sleep till 7. I then get up, walk the dogs for an hour, come home and have breakfast about 8.30.

I think the timing of your lantus injections are as important as the dosage. My hopsital people didn't encourage me to do it, but they couldn't help me to stop the hypos, so I did it anyway, and I am so glad that I did.

Good luck to you, I used to run round the house screaming and naked, and start screaming out the fron door 'help me, help me'-as at the time my husband was working nights-my neighbours say they never heard me screaming, and sometimes the milk delivery person would find me, and doing some other very stupid and dangerous things. I hope this helps, and encourages you that life can be pretty much hypo free...don't give up trying.....

 

[eabhamurphy]

Thanks for the tips guys.

I take my lantus at around 11pm, I dont think it would be possible for me to take it earlier as I usually out of the house until 10.30pm...i suppose i could bring it with me,not like it is huge or anything..

Ive been making sure my BG is above 5.5 before I go to sleep and this seems to be preventing any middle of night hypos.

Its all such an adjustment this diabetes thing, feels a little surreal still.

But it is so great to be able to ask questions and recieve such helpful replies.hope im able to help people deal with diagnosis in the future.

Thanks again,

Eva

 

[bmtest]

Thanks Ken

4 is low in the morning I agree but thats how I like it I love my morning sugar puffs, I rush off early in the morning to work and if's it's low it saves me testing before I let the dogs out, as long as I can stand to have a wash and comb my hair before having breakfast that all I am interested in..

I have a tolerance to readings of 1.9, I have trained for years operating on low readings and you do get used to it believe it or not and take it from me I have never passed out to date 30 year on, it's a case of how low can you go.



.

 

[cugila]

Hi bmtest.

It concerns me when you state that you are happy to run at such low levels ( 1.9). You may be able to do it but have you investigated the possible dangers to your health (brain) by doing such low numbers.

I recently posted something about this and it made frightening reading and made me want to keep my numbers above 4. Anything below is Hypoglycaemic and it shouldn't be the norm. It is just as bad for you as being Hyperglycaemic.

Ken.

 

[bmtest]

Hi Ken

Yes I have noticed the changes in how my brain has changed if you like it is always in what you would call DOS prompt mode for 99% of the time.

I have seen diabetics with this type of damage but as I have said I keep saying I have never passed out and they are blips in control. If I go out on a 12 mile run with the running club on an evening session sometimes you do hit the low bllod levels but if you think of the man hours you are on this earth the blips in control are nothing.